NURSING PNP401 Case Study # 2 - Lower GI disorder: Tommy, a 56-year-old school counselor.

Section: PNP401KDD Grade /30 (15% WT) Case Study # 2 - Lower GI disorder Tommy, a 56-year-old school counselor, has come into the gastroenterologist office for recurrent mild to severe cramping in his abdomen and blood-streaked stool. Here are the findings of the initial nursing assessment upon his arrival to the clinic: • Mildly obese man • Guarding of his abdomen with both direct and rebound tenderness, especially in the left lower quadrant (LLQ) • BP: 168/98, HR: 110, RR: 24, Temp: 38 degrees • Slightly diaphoretic • He reports that he has periodic constipation. • He reports previous episodes of abdominal pain but this time “the pain is getting worst” Tommy’s past medical history: • A sedentary job with “lots of emotional draining moments”. • Smoked a pack of cigarettes a day for the past 20 years. • Drinks 2-3 large cans of beer every evening until 3 months ago. • Diet consists of white bread, meat, ice cream and nuts. • He denies history of cardiac or pulmonary problems • No personal history of cancer • Father and older brother died of colon cancer • Not on any medications